An analytical study of drug utilization, disease progression, and adverse events among 165 COVID-19 patients.

4区医学

Annals of translational medicine Pub Date : 2021-02-01 DOI:10.21037/atm-20-4960

Feng Sun, Hao Kou, Shengfeng Wang, Yun Lu, Houyu Zhao, Wenjing Li, Qingxin Zhou, Qiaoli Jiang, Yinchu Cheng, Kun Yang, Lin Zhuo, Yang Xu, Dongfang Wu, Siyan Zhan, Hong Cheng

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引用次数: 8

Abstract

Background: The coronavirus disease 2019 (COVID-19) epidemic has lasted for nearly 4 months by this study was conducted. We aimed to describe drug utilization, disease progression, and adverse drug events of COVID-19.

Methods: A retrospective, single-center case series study enrolled 165 consecutive hospitalized COVID-19 patients who were followed up until March 25, 2020, from a designated hospital in Wuhan. Patients were grouped by a baseline degree of severity: non-severe and severe. An analytical study of drug utilization, disease progression, and adverse events (AEs) of COVID-19 was conducted.

Results: Of the 165 COVID-19 cases, antivirals, antibacterials, glucocorticoids, and traditional Chinese medicine (TCM) were administered to 92.7%, 98.8%, 68.5%, and 55.2% of patients, respectively. The total kinds of drugs administered to the severe subgroup [26, interquartile range (IQR) 18-39] were 11 more than the non-severe subgroup (15, IQR 10-24), regardless of comorbidities. The 2 most common combinations of medications in the 165 cases were 'antiviral therapy + glucocorticoids + TCM' (81, 49.1%) and 'antiviral therapy + glucocorticoids' (23, 13.9%). Compared with non-severe cases, severe cases received more glucocorticoids (88.5% vs. 66.2%, P=0.02), but less TCM (50.0% vs. 63.3%, P=0.20), and suffered a higher percentage of death (34.6% vs. 7.2%, P=0.001). At the end of the follow-up, 130 (78.8%) patients had been discharged, and 24 (14.5%) died. There were 13 patients (7.9%) who had elevated liver enzymes, and 49 patients (29.7%) presented with worsening kidney function during the follow-up.

Conclusions: Of the 165 COVID-19 patients, the fatality rate remained high (14.5%). Drug utilization for COVID-19 was diverse and generally complied with the existing guidelines. Combination regimens containing antiviral drugs might be beneficial to assist COVID-19 recovery. Additionally, liver and kidney AEs should not be ignored.

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165例COVID-19患者药物使用、疾病进展及不良事件分析研究

背景:本研究开展时，2019冠状病毒病(COVID-19)疫情已持续近4个月。我们的目的是描述COVID-19的药物使用、疾病进展和药物不良事件。方法:采用回顾性、单中心病例系列研究，纳入武汉市某定点医院165例连续住院的COVID-19患者，随访至2020年3月25日。患者按基线严重程度分组:非严重和严重。对COVID-19的药物利用、疾病进展和不良事件(ae)进行分析研究。结果:165例新冠肺炎患者中，使用抗病毒药物的占92.7%，使用抗菌药物的占98.8%，使用糖皮质激素的占68.5%，使用中药的占55.2%。不论合并症如何，重症亚组[26，四分位间距(IQR) 18-39]的用药种类比非重症亚组(15,IQR 10-24)多11种。165例患者中最常见的2种药物组合是“抗病毒治疗+糖皮质激素+中药”(81例，49.1%)和“抗病毒治疗+糖皮质激素”(23例，13.9%)。与非重症患者相比，重症患者使用糖皮质激素较多(88.5%比66.2%，P=0.02)，而使用中药较少(50.0%比63.3%，P=0.20)，死亡率较高(34.6%比7.2%，P=0.001)。随访结束时，出院130例(78.8%)，死亡24例(14.5%)。随访期间肝酶升高13例(7.9%)，肾功能恶化49例(29.7%)。结论:165例新冠肺炎患者病死率居高不下(14.5%)。COVID-19的药物使用多种多样，总体上符合现有指南。含有抗病毒药物的联合治疗方案可能有助于COVID-19的恢复。此外，肝脏和肾脏不良反应也不应被忽视。

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来源期刊

Annals of translational medicine Multiple-

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769

期刊介绍： The Annals of Translational Medicine (Ann Transl Med; ATM; Print ISSN 2305-5839; Online ISSN 2305-5847) is an international, peer-reviewed Open Access journal featuring original and observational investigations in the broad fields of laboratory, clinical, and public health research, aiming to provide practical up-to-date information in significant research from all subspecialties of medicine and to broaden the readers’ vision and horizon from bench to bed and bed to bench. It is published quarterly (April 2013- Dec. 2013), monthly (Jan. 2014 - Feb. 2015), biweekly (March 2015-) and openly distributed worldwide. Annals of Translational Medicine is indexed in PubMed in Sept 2014 and in SCIE in 2018. Specific areas of interest include, but not limited to, multimodality therapy, epidemiology, biomarkers, imaging, biology, pathology, and technical advances related to medicine. Submissions describing preclinical research with potential for application to human disease, and studies describing research obtained from preliminary human experimentation with potential to further the understanding of biological mechanism underlying disease are encouraged. Also warmly welcome are studies describing public health research pertinent to clinic, disease diagnosis and prevention, or healthcare policy.  With a focus on interdisciplinary academic cooperation, ATM aims to expedite the translation of scientific discovery into new or improved standards of management and health outcomes practice.